Characteristics, treatment patterns and healthcare resource use of Finnish men with prostate cancer

芬兰前列腺癌男性患者的特征、治疗模式和医疗资源利用情况

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Abstract

OBJECTIVES: To characterize patients diagnosed with prostate cancer (PC) in Finland in 2015-2019 and to follow-up the treatment patterns and healthcare resource use for patients with nonmetastatic PC (nmPC) and metastatic PC (mPC) until the end of 2020. PATIENTS AND METHODS: PC cases were identified from the Finnish Cancer Registry and the Care Register for Health Care. Data on inpatient and outpatient diagnoses, outpatient medicine use and sociodemographics were sourced from nationwide registers. Data on Gleason scores and in-hospital medication were available for a subset of the patients. RESULTS: In total, 25 045 men were diagnosed with PC in 2015-2019. The median age was 71 years, and 28% of these cases were considered as de novo mPC or progressed to mPC within one year from diagnosis. Of the whole cohort with PC, 1368 (5.5%) died within one year (2.3% from PC). Altogether, 70% received active treatment within one year from diagnosis (nmPC cohort: 59%; mPC cohort: 97%). In the nmPC cohort, the most common treatments within the first year were radiotherapy (31%), androgen deprivation therapy (ADT) (25%) and radical prostatectomy (25%). In the mPC cohort, ADT (92%), radiotherapy (38%) and first-generation antiandrogens bicalutamide or flutamide (22%) were the most common first-year treatments. The use of first-generation antiandrogens declined, and the use of second-generation antiandrogens increased towards the end of the study period. The total number of all-cause healthcare contacts per patient year was higher for mPC than for nmPC (61 vs. 29 contacts). CONCLUSIONS: This large nationwide cohort study suggests that, in Finland, PC is generally diagnosed in the localized phase. As expected, the disease burden seems to be higher among men with metastatic disease. The estimated high proportion of patients with mPC at or soon after diagnosis should be interpreted with caution.

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